93 Decision Citation: BVA 93-05019
Y93
BOARD OF VETERANS' APPEALS
WASHINGTON, D.C. 20420
DOCKET NO. 91-52 509 ) DATE
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THE ISSUES
1. Entitlement to service connection for peripheral
neuropathy.
2. Entitlement to service connection for a neck disorder.
3. Entitlement to restoration of a 60 percent evaluation
for a left below-the-knee amputation, currently evaluated as
40 percent disabling.
4. Entitlement to an increased evaluation for a low back
disorder, currently evaluated as 10 percent disabling.
5. Entitlement to an increased evaluation for a psychiatric
disorder, currently evaluated as 50 percent disabling.
REPRESENTATION
Appellant represented by: Veterans of Foreign Wars
of the United States
WITNESS AT HEARING ON APPEAL
Appellant
ATTORNEY FOR THE BOARD
J. Horrigan, Counsel
INTRODUCTION
The veteran served on active duty from December 1962 to June
1963 and from October 1963 to January 1970.
This matter came before the Board on appeal from an April
1991 rating decision from the Reno, Nevada, Regional Office
(RO) which reduced the evaluation for the veteran's left
below-the-knee amputation from 60 percent to 40 percent
disabling, effective November 14, 1990. The notice of
disagreement was received on June 17, 1991. The statement
of the case was issued on June 27, 1991. In August 1991,
the veteran appeared and gave testimony at a hearing before
a hearing officer at the RO. After his claim was again
denied, a supplemental statement of the case was issued on
September 20, 1991. The veteran's substantive appeal was
received on November 18, 1991. The case was received at the
Board of Veterans' Appeals on December 31, 1991, and
docketed for appeal on January 6, 1992. The veteran has
been represented during his appeal by the Veterans of
Foreign Wars of the United States, to which the file was
referred. That organization submitted written arguments to
the Board on April 24, 1992. The case is before the Board
for appellate consideration at this time.
REMAND
A review of the record reveals that the veteran is also
seeking service connection for peripheral neuropathy and a
neck disorder as secondary to his left below-the-knee
amputation as well as increased evaluations for his
service-connected low back disorder and psychiatric disorder
resulting from his amputation. These issues are
inextricably intertwined with that of an increased
evaluation for a left below-the-knee amputation but they
have not been developed and certified for appeal.
A review of the record reveals that the veteran receives
considerable treatment at the Department of Veterans Affairs
(VA) Medical Center in Reno, Nevada, for the disorders
currently at issue but no clinical records from this
facility since May 1989 are in the claims folder aside from
records reflecting a brief hospitalization in June 1991. In
addition, the veteran has reported receiving treatment at
the VA Medical Center in Seattle, Washington, for his left
below-the-knee amputation, but no clinical records
reflecting this treatment are on file. Finally, the
veteran's representative has asserted that his last physical
examination, conducted in October 1990, was inadequate.
In view of the above, and given the duty to assist the
veteran in the development of his claim under the provisions
of 38 U.S.C.A. 5107(a) (West 1991), this case is REMANDED to
the RO for the following action:
1. Copies of all clinical records
documenting the veteran's treatment since
May 1989 at the VA Medical Center in
Reno, Nevada, and all records from the VA
Medical Center in Seattle, Washington,
should be obtained and associated with
the claims folder.
2. Thereafter, the veteran should be
given a special orthopedic examination to
determine the current degree of severity
of his service-connected left leg
amputation and low back disorder and the
nature, severity, and etiology of the
veteran's claimed neck disorder. All
appropriate special studies should be
performed and all clinical findings
reported in detail. The claims folder
must be made available to the examining
physician prior to the evaluation so that
he/she may study the pertinent clinical
record in detail. At the conclusion of
the evaluation, the examiner should
express an opinion regarding the
relationship between any neck disorder
found and the veteran's service-connected
left leg amputation.
3. The veteran should also be given a
special neurological examination to
determine the nature and severity of his
reported neurological disorder, claimed
as peripheral neuropathy. Any
appropriate studies should be performed
and all pertinent clinical findings
reported in detail. The claims folder
must be made available to the examining
physician prior to the evaluation so that
he/she may study the pertinent clinical
record in detail. At the conclusion of
the evaluation, the examiner should
express an opinion regarding a
relationship between any neurological
disorder found and the veteran's left
below-the-knee amputation.
4. Thereafter, the veteran should also
be given a special psychiatric
examination to determine the current
severity of his service-connected
post-traumatic stress disorder. All
necessary special studies should be
performed and all pertinent clinical
findings reported in detail. The claims
folder must be made available to the
examining physician prior to the
evaluation so that the pertinent clinical
records can be studied in detail.
When the above development has been completed, the RO should
adjudicate the issues of service connection for peripheral
neuropathy and a neck disorder. In addition, the RO should
again adjudicate the issues of increased evaluations for a
left below-the-knee amputation, a low back disorder, and a
psychiatric disorder after consideration of all applicable
regulations and the total history of these disabilities as
mandated by Schafrath v. Derwinski, U.S. Vet. App.
No. 89-114 (November 26, 1991). If these issues remain
denied, the veteran and his representative should be
provided with a supplemental statement of the case and
afforded a reasonable opportunity to respond. Thereafter,
the case should be returned to this Board for its further
consideration, if in order.
No action is required of the veteran until he is so
informed. The purpose of this REMAND is to obtain
additional, clarifying, clinical evidence and to ensure that
the veteran receives due process of law. By this REMAND,
the Board intimates no opinion as to the outcome in this
case.
BOARD OF VETERANS' APPEALS
WASHINGTON, D.C. 20420
ANTHONY FAVA CHARLES E. EDWARDS, M.D.
H. H. CLARK
Under 38 U.S.C.A. § 7252 (West 1991), only a decision of the
Board of Veterans' Appeals is appealable to the United
States Court of Veterans Appeals. This remand is in the
nature of a preliminary order and does not constitute a
decision of the Board on the merits of your appeal. 57 Fed.
Reg. 4126 (1992) (to be codified as 38 C.F.R. § 20.1100(b)).